John D. Halamka MD Academic and Research Computing

BIDMCINFORMATION SYSTEMS

OPERATING PLANFY08

Information Systems FY08 Operating Plan

IntroductionThis document outlines the BIDMC Information Systems FY08 Operating Plan. In FY08, we will again align our goals with the operating goals of our customers. Highlights include: 1. Support for rollout of 500 active RFID equipment tags2. Design and development of enhancements for CPOE gap areas such as ED, NICU, and procedure areas.3. Implement Inpatient Medication reconciliation as part of electronic history and physical documentation4. Continued OR enhancements, including "big boards", PAT documentation (medication reconciliation, nursing assessment form) and web-based versions of the CCC PACU logs, that all are integrated with OR Scheduling5. Continued work on automating clinical documentation and scanning 6. Continued enhancement of e-Prescribing including pharmacy initiated renewals 7. Bar coding of all medications by pharmacy leading to electronic medication administration records in 20098. Supporting the effort to standardize use of clinical applications such as webOMR across BIDMC9. Begin Theradoc planning10. Rewrite Patientsite and implement the Google pilot

We have developed this Operating Plan based on discussions with our customers within BIDMC. We will use this plan throughout the year as a yardstick to evaluate our performance in meeting our goals. All levels of Information Systems staff have contributed to the Operating Plan and are committed to seeing that these promises to the BIDMC community are fulfilled.

It is very important to us that the customers of Information Systems are fully aware of our activities and plans. We will be keep all stakeholders informed about our progress on the Operating Plan throughout the year. We value your feedback and welcome any comments or questions on the initiatives described in this plan.

John D. Halamka MD


Academic and Research Computing

Leader: Steve Berry

Strategy: To select, design, implement, and support research administrative applications, including grants management, human subjects monitoring, and compliance education.

Goals for FY08: Participate in CTSA planning and technology development processes Support the Grants.Gov requirement for electronic grant submissions (S2S build) Implement IRB and Human Subjects tracking tools (Human Subject Enrollment

rollout) Implement new Animal Protocol and Animal Ordering Management Tracking

System (Topaz solution) Provide space, grant activity, and animal management reports to research

administration

Staffing:Director4 Analysts/Programmers 2 Desktop and application support specialists

Clinical Development

Leader: Larry Markson

Strategy: To design, build and maintain clinical systems.

Goals for FY08: Enhance e-Prescribing to include pharmacy initiated renewals Implement Inpatient Medication reconciliation as part of electronic history and

physical documentation


Implement new POE order sets to support Clinical Pathways and other clinical processes as prioritized by the new COEC subcommittee

Develop a plan and begin the implementation of POE in the NICU, ED, and Procedure areas.

Implement enhancements to webOMR as prioritized by the webOMR Users Group

Design electronic progress note documentation Collaborate with MA-Share to implement automated electronic hospital discharge

summary and ED summary transmission to community clinicians Continued OR enhancements, including "big boards", PAT documentation

(medication reconciliation, nursing assessment form) and web-based versions of the CCC PACU logs, that all are integrated with OR Scheduling

Support scanning of outpatient documents as needed to support standardization of webOMR utilitization at BIDMC

Implement the Oncology Management System for the inpatient setting. Enhance and continue to roll out results notification in webOMR. Migrate the remaining CCC applications used by clinicians to the web by FY08 Design and build interfaces to SoftLab as needed to support the LIS

implementation Support existing CCC applications

Staffing:Director 4 Managers20 Programmers

Clinical Systems

Leader: Karen Rapuano

Strategy: To select, implement, and support clinical applications

Goals for FY08:

Critical Care Continue implementation of IMDSoft in the MICU and NICU. Investigate the

possibility of viewing summary flowsheets on the web. Complete implementation of OBTV in the Emergency Department Plan and begin implementation of upgrade to OBTV in OB Provide IS support for the new Transplant Institute Support existing systems including, CareVue, CompuRecord, Trauma Registry,

OTTR (Transplant), and OBTraceVue

Inpatient: Positive Patient ID


Patient Wristbands: Begin evaluating bar-coded wristbands for outpatients

Employee Badges: Continue pilot and rollout of employee bar-coded badges

Electronic Medication Administration: Collaborate with IS Development, Pharmacy and Nursing to begin planning the eMAR implementation

Provide staff support to the new COEC POE Committee Begin workflow analysis and project planning for Theradoc Infection Control

Monitoring Support existing systems including: Incident Reporting, Call Center, POE and

eTicket.

Clinical Laboratory/Cardiology Provide application support for the CVI Continue implementation of the SCC Laboratory System Implement MAC Lab/Cardio Lab software and hardware upgrade Implement registries as prioritized by the Registry Committee Relocate Cardiology hardware to an IS managed data center Support existing systems including: Apollo, Atrium, cardiology registries and

Gemnet

Radiology/Radiation Oncology Complete the development of a long term strategy for the radiology information

system Complete the development of a multi-year Global PACS strategy in conjunction

with IS Infrastructure Team Implement enhanced functionality for IMPAC including an automated ADT

interface and remote access Support existing systems including: Impac, Cyberknife and associated clinical

systems

Ambulatory Support efforts to standardize use of webOMR in all clinical areas. Implement

view/order entry version for appropriate clinicians. Develop a plan for providing eClinicalWorks application and infrastructure

support to non-owned BIDPO clinicians Support existing systems including: PatientSite, g-Care, WebOMR, Logician and

CareTracker

Staffing: 1 Director 4 Managers24 Analysts


Decision Support Systems

Leader: Carolyn Conti

Strategy: To implement decision support systems, including data warehousing, master physician directory, web-based reporting, and workflow applications.

Goals For FY08: Implement reports and workflow dashboards in Performance Manager as needed

to support organizational needs. Implement clinical data marts as needed to enable quality measurement and

decision support activities Develop interfaces to support the 3M HRM coding/workflow application and the

LIS implementation Continue to enhance the diabetes outcome registry to support quality

measurement and pay for performance requirements Develop reports to support patient and employee vaccination programs Support Cactus and NEHEN Express users

Staffing: Manager 1 Programmer2 Analysts2 SQL Developers


Database Services

Leader: Don Wood

Strategy: To deploy, maintain and optimize databases.

Goals for FY08 Complete SQL2005 and clustering implementations Implement performance monitoring and auditing tools Support all existing SQL, Oracle and MySQL databases

Staffing: Manager8 DBAs

Finance and Administration

Leader: Jeanette Blackler

Strategy: To create, manage and track operating and capital budgets.

Goals for FY08: Support the core IS Budgeting function Support capital project expenditure tracking and reporting Support asset management reporting

Staffing:Manager2 Analysts

Fiscal Systems

Leader: Steve Herzog

Strategy: Provide support and assistance in the selection and implementation of critical financial based software applications that will improve the hospitals overall Revenue Cy-cle, Human Resources, Payroll, Research and Supply Chain operations.

Goals for FY08


Implementation: Implement additional non NEHEN processing capabilities to payers that are not

currently NEHEN members in support of PFS Revenue Cycle improvement op-portunities.

Design and implement improved Rate Setting data quality standards to DHCFP Implement enhanced BIDMC Case Mix capabilities to reflect all of the data sub-

mitted to DHCFP Implement additional automated Patient Claims Status Inquiry (HIPAA 276/277)

capabilities as a process improvement opportunity for PFS Complete the implementation of the new PeopleSoft IS support staffing model Further deploy beyond the initial pilot sites the NuvoSoft "Who-To" application Commence with the PeopleSoft V8.9 Financial applications upgrade project Commence with the upgrade of the PeopleSoft HRMS and Payroll applications to

version 8.9 Implement new HIM data feeds from the 3M HRM product to IBAX and Case

Mix

Support: Support the existing BIDMC Fiscal and Decision Support based applications Implement CCC/IBAX revenue cycle enhancements as prioritized by Patient Ac-

cess Services and Patient Financial Services Provide eGate and HIPAA transaction support to all BIDMC customers Support all SoftLab and 3M HRM Data Integration requirements

Staffing:Vice President Fiscal Information systems4 Managers16 Programmer Analysts4 Integration Specialists

Health Information Management

Leader: Gerry Abrahamian

Strategy: To support the transition from paper documentation to electronic while ensuring the integrity, functionality and legal aspects of electronic solutions.

Goals for FY08: Contiue to implement the five year clinical documentation plan. Assuring that

processes for systems developed allow entries that will be complete, accurate, timely, and authenticated.

Improve the quality and timeliness of completion of clinical documentation through the HIM Committee structure

Work through the Forms Committee to approve new e-forms and develop procedures related to implementation

Complete the inpatient and outpatient scanning implementations


Provide support and manage change requests for the existing Case Management Documentation system with integration to McKesson electronic level of care system and the DRG.

Deploy new eScription implementations in Rad/Onc, BID-Needham, other Departmental requests and handheld deployments.

Support efforts to standardize use of webOMR in all clinical areas

StaffingDirector 2 Managers


IS Support Services

Leader: Margaret Hyland

Strategy: To provide support, service and maintenance of all equipment. To develop policies and processes based on best practices to optimize and enhance the use of technology resources and improve the overall support provided to users. To optimize budget and financial management through evaluation and implementation of technologies, standardization and management of the environment.

Goals for FY08:Server/Messaging and Desktop Engineering:

Continue development of a thin client solution for clinical areas. Evaluate Exchange 2008 and plan an upgrade project. Extend High Availability of Services: Create a new SQL Cluster, Extend

MetaFrame services. Enhance Desktop Management utilizing GPO management. Expand DFS namespace for ePHI stored in Shared Directories and explore

possibilities for creating a Patient Data Cluster. Continue efforts to consolidate Wintel servers. Explore possibilities and potential opportunities for centralizing and consolidating

Infrastructure operational monitoring and reporting systems

IS Help Desk Account Management Improvements:

Improve and enhance all processes for implementing moves/adds/changes in LDAP/AD related to BIDMC and affiliated entities employees and staffs.

Exploring the use of a self service “Secret Question” approach to ITS Password Resets.

File Services: Reclaim file services storage through enforcement of technology use

policies. Identify ePHI stored in File Services Shared Directories and apply

stronger access controls to shares and move into DFS namespace. Upgrade McAfee’s ePolicy Orchestrator to 4.0 and Viruscan to 8.5i Maintain the application registry with updated SLA, downtime requirements and

impact classifications on all applications currently residing on and supported by the Windows Server/Workstation environment.

On-Site and Off-Site Technical Support: Implement DHCP services for BIDMC off-site locations and BIH-Needham. Work with Network Services to implement a network upgrade at BID-Needham. Continue the work to finish the implementation of SMS services to the BIDMC

off-site locations and BIH-Needham. Eliminate the NT4 Operating System from all BIDMC workstations.

Asset Management/Inventory Control:


Continue to renew and update the IS Support Portal and work on new IS webparts.

Hardware Life-Cycle Management: Continuing to maintain the established Hardware Life Cycle on all Data Center Servers (5-years), Workstations (5 years) and Printers (7 years).

Power Consumption Monitoring and Conservation: Decrease overall power consumption through power management activities and working with hardware vendors/manufacturers to purchase and deploy equipment that saves on electrical consumption; e.g., replacing CRTs with FP’s.

Continued participation in RASMAS (Risk and Safety Management Alert System) in order to respond in a timely manner to IT product alerts.

Technology Project Management and Application Support: Manage and support BIDMC non-clinical projects through all phases of the

project; e.g., PanGo, HIM Inpatient Scanning, InfoGenesis Revelation; as well as provide technical management and support for various application/solution upgrades and maintenance.

Provide Application Support various applications such as: Captiva InputAccel v5.2, NetManage OnWeb, PanGo Locator 4.1 (pilot phase).

Establish a single point of contact for customers (internal and external to the IS Department) who are seeking assistance with new infrastructure projects

Improve visibility to centralized/standardized project tasks, status and performance through the use of common, web-based, project management tools (e.g., Microsoft Enterprise Project Management solution).

Staffing: Director4 Managers1 Supervisor8 Engineers 2 Project Coordinators 1 Move Coordinator28.75 Support Specialists Media ServicesLeader: Peter Macaulay

Strategy: To provide photography, graphics and video services

Goals for FY08: Support video over IP as needed for CareLink, Stroke consultation and other

telemedicine projects Implement electronic conference rooms Collaborate with facilities to refurbish the Kirstein space Complete a 5 year media services strategic plan Continue to support the photography, graphics, and video needs of BIDMC

Staffing:DirectorManager


6 Media Specialists6 Media Associates

Medical Library ServicesLeader: Margo Coletti

Strategy: The Medical Library Services provides knowledge based information resources to Medical Center staff and students. Working in collaboration with other branches of IS, work to develop standards, expand electronic resource collections, and improve access to knowledge bases. .Goals for FY08:

Continue print-to-online migration and establish the medical library as an infor-mation commons

Continue to support the prohibited abbreviations initiative Continue to support knowledge resources on the BIDMC portal

Staffing:Director3.1 Medical Librarians

Network Services

Leader: Hal MacGregor

Strategy: To provide a secure, life cycle managed, state of the art network core, distribution and access layer.

Goals for FY08: Support widespread deployment of RFID asset tracking tags Support the lifecycle management of the entire CareGroup network Support activation of CLS building and east campus backfill

Staff: Manager5 Network engineers2 Network technicians


Technical Systems Support

Leader: Rocky Grasso

Strategy: To support the server and storage infrastructure of BIDMC.

Goals for FY08: Implement disk-to-disk backup technology as replacement for disk-to-tape to

support faster recoveries and less data loss in the event of a disaster Migrate Cache production environments to Linux

Staffing:1 Manager4 MVS and Unix Systems Engineers2 Storage Systems Engineers2 Caché Systems Engineer

Production Operations

Leader: Bob Doherty

Strategy: Support data center and production operations at BIDMC.

Goals for FY08: Add redundant interruptible power support to Ren data center Replace Ren data center power distribution units to improve electrical efficiency

and monitoring capability

Staffing: 1 Manager1 Supervisor4 Production Control Analysts8 Computer Operators


Security

Leader: Mark Olson

Strategy: To provide a safe and secure computing environment via detection and proactive measures. Coordinate IS disaster recovery planning activities.

Goals for FY08: Create policies and documentation as needed to support a secure environment Track the HIPAA compliance of our major applications in collaboration with

application owners and data stewards Provide intrusion detection and prevention services Implement Phase II of Palmer / Baker / Span Data Center disaster recovery plan Install and activate web content filtering and monitoring system. Enhance Operational Systems Monitoring

StaffingManagerPolicy EngineerSenior Security Engineer

Telecommunications

Leader: Sandra Denekamp

Strategy: To support all voice communications devices and services including the PBX equipment at both the Medical Center and at off-sites and affiliated locations, all cable design and installation for voice and data systems, closet layout, data port activations and all telephone directories

Goals for FY08:


Install new riser in Kirstein building Complete installation of private fiber backup from RCN Support activation of CLS Building and east campus backfill Begin 3 year phased relocation of Deaconess sub-basement telephone room to

PBS basement

Staffing:ManagerSupervisorProject coordinator1.8 Analysts4 Telecommunication Technicians

Web Applications and Applied Informatics

Leader: Qiang Wang

Strategy: To implement the content management, search and integration tools that power the CareGroup extranet and intranet.

Goals for FY08 Continue to enhance the new intranet portal as prioritized by the portal steering

committee Collaborate with Corporate Communications to select a new external website

content management system Continue to Integrate Patientsite with Google Health Finish planning and begin to rewrite Patientsite in .NET with a service oriented

architecture. Create web Services as needed for integration of existing applications into the

new portal and for interactivity with external collaborators

Staffing:Manager


4 programmers1 Web Administrator

Beth Israel Deaconess Hospital-Needham

Leader: Steve O’Halloran

Strategy: To understand, support, and define strategic direction of all current and future environments related to Information Systems at BID-Needham

Goals for FY08 Establish a complete and thorough understanding of the IT environment at BID-

Needham Establish effective relationships with support and management teams at BIDN,

BIDMC, MTA, and NEB Co-develop, share, and publish strategic planning options and direction for the

hospital with the administration team at BID-Needham Partner with Physicians at BID-Needham throughout 2008 to establish and

develop IT initiatives that will improve physician workflow related to patient data access and patient care

Successfully manage the IT operational and capital budget throughout FY 2008 and plan accordingly for FY 2008 capital budget requests based on a synergy with the strategic direction of BID-Needham.

Information Systems Initiatives at BID-Needham: MRI Installation Begin implementation of Meditech's Nurse Documentation module Support physician EMR's through Iatrics POI

Staffing:Director4.5 FTE’s made up of BIDMC desktop support/MTA analysts/NEB analyst

John D. Halamka MD Academic and Research Computing

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